Provider Demographics
NPI:1255581732
Name:BRAINARD, ADELE HARMAN (LCSW)
Entity type:Individual
Prefix:
First Name:ADELE
Middle Name:HARMAN
Last Name:BRAINARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4591 ARROYO RD.
Mailing Address - Street 2:BUILDING 62, RM 548
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550
Mailing Address - Country:US
Mailing Address - Phone:925-373-4700
Mailing Address - Fax:925-449-6525
Practice Address - Street 1:4591 ARROYO RD.
Practice Address - Street 2:BUILDING 62, RM 548
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550
Practice Address - Country:US
Practice Address - Phone:925-373-4700
Practice Address - Fax:925-449-6525
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC2115174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist